Does Kidney Donor Risk Index implementation lead to the transplantation of more and higher-quality donor kidneys?
|
|
- Jordan Evans
- 6 years ago
- Views:
Transcription
1 Nephrol Dial Transplant (2017) 32: doi: /ndt/gfx257 Advance Access publication 21 August 2017 Does Kidney Donor Risk Index implementation lead to the transplantation of more and higher-quality donor kidneys? Ester Philipse 1, Alison P.K. Lee 2, Bart Bracke 3, Vera Hartman 3, Thierry Chapelle 3, Geert Roeyen 3, Kathleen de Greef 3, Dirk K. Ysebaert 3, Gerda van Beeumen 1, Marie-Madeleine Couttenye 1, Amaryllis H. Van Craenenbroeck 1, Rachel Hellemans 1, Jean-Louis Bosmans 1 and Daniel Abramowicz 1 1 Department of Hypertension-Nephrology, Antwerp University Hospital, Antwerp, Belgium, 2 Department of Hypertension-Nephrology, AZ Klina, Brasschaat, Belgium and 3 Department of Hepatobiliary, Transplantation and Endocrine Surgery, Antwerp University Hospital, Antwerp, Belgium Correspondence and offprint requests to: Ester Philipse; esterphi@gmail.com ABSTRACT Keywords: graft survival, Kidney Donor Profile Index (KDPI), Kidney Donor Risk Index (KDRI), kidney transplantation Background. The Kidney Donor Risk Index (KDRI) is a quantitative evaluation of the quality of donor organs and is implemented in the US allocation system. This single-centre study investigates whether the implementation of the KDRI in our decision-making process to accept or decline an offered deceased donor kidney, increases our acceptance rate. Methods. From April 2015 until December 2016, we prospectively calculated the KDRI for all deceased donor kidney offers allocated by Eurotransplant to our centre. The number of the transplanted versus declined kidney offers during the study period were compared to a historical set of donor kidney offers. Results. After implementation of the KDRI, 26.1% (75/288) of all offered donor kidneys were transplanted, compared with 20.7% (136/657) in the previous period (P < 0.001). The median KDRI of all transplanted donor kidneys during the second period was 0.97 [Kidney Donor Profile Index (KDPI) 47%], a value significantly higher than the median KDRI of 0.85 (KDPI 34%) during the first period (P ¼ 0.047). A total of 68% of patients for whom a first-offered donor kidney was declined during this period were transplanted after a median waiting time of 386 days, mostly with a lower KDRI donor kidney. Conclusions. Implementing the KDRI in our decision-making process increased the transplantation rate by 26%. The KDRI can be a supportive tool when considering whether to accept or decline a deceased donor kidney offer. More data are needed to validate this score in other European centres. INTRODUCTION Long-term survival is better for patients who receive a kidney transplant, compared with those who remain on dialysis [1]. However, the number of patients on the transplant waiting list still exceeds the number of suitable deceased donor kidneys. To expand the kidney donor pool, the dichotomous standard criteria donor (SCD) and extended criteria donor (ECD) classification was introduced in 2002 [2]. This led to a dilemma for the clinician whether to accept an ECD kidney, associated with a relative risk of allograft loss >1.7 compared with a kidney recovered from a SCD, or to let the patient remain on dialysis knowing the mortality risk while waiting for the next offer. In 2009, Rao et al. developed the Kidney Donor Risk Index (KDRI) as a decision-making tool for the clinician [3]. This is a continuous risk score, based on the association of 10 donor characteristics with graft survival. The 10 factors include age, height, weight, ethnicity, history of hypertension and/or diabetes, cause of death, serum creatinine, hepatitis C virus (HCV) serology and donation after cardiac death (DCD). The association between these 10 donor characteristics and graft survival was determined by using a multivariable Cox proportional hazard regression model on adult recipients of ABO blood type-compatible, first-time, deceased donor kidney-only transplants from 1995 to VC The Author Published by Oxford University Press on behalf of ERA-EDTA. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For Downloaded from commercial re-use, please contact journals.permissions@oup.com 1934
2 The KDRI gives an estimate of the relative risk of posttransplant kidney graft failure for a particular deceased donor compared with the median donor. Nowadays, the median donor (50th percentile) is set equal to the median donor of all deceased donors in the USA from whom a kidney was recovered for the purpose of transplantation during the prior calendar year. The median donor has thus, by definition, a KDRI of 1. Higher values are associated with higher estimated risk of graft failure. For example, a donor kidney with a KDRI of 1.28 has an estimated risk of graft failure that is 1.28-fold that of the median donor. With an increase in KDRI there is a gradual decrease in graft survival [3]. Based on the KDRI, the Kidney Donor Profile Index (KDPI) was determined. The KDPI is a numerical mapping of the KDRI that expresses the quality of a particular deceased donor kidney relative to other donor kidneys. For example, a donor kidney with a KDPI of 90% has a KDRI >90% of all recovered donor kidneys during the previous calendar year. The KDRI/KDPI calculator is freely accessible on the web ( resources/allocationcalculators.asp?index¼81) [4] allowing its calculation for each donor offer. The KDRI/KDPI scores are already routinely used in the USA. Indeed, the 20% bestrecovered organs (those with the 20% lowest KDRI/KDPI) are preferentially allocated to the recipients with the estimated highest longevity in order to maximize the number of life-years gained by transplantation. Of note, several donor characteristics that are thought to be associated with post-transplant graft loss, such as female donor sex or smoking history, were not significant predictors of graft loss in the Rao analysis. These characteristics are sometimes put forward as a reason to decline a donor within our transplant unit. Therefore, we hypothesized that calculating and basing our decision to accept or decline a donor on the KDRI/KDPI, instead of on other, less-validated parameters, might help us to increase the acceptance rate of highquality donor kidneys. Previously, our group retrospectively calculated the KDRI for all offered deceased donor kidneys in our centre (Antwerp University Hospital) from January 2010 until December This study showed that the KDRI/KDPI of all transplanted donor kidneys was quite low, suggesting that we might decline too many offers. Only 20.7% of all deceased donor kidneys offered to one of our patients on the transplant waiting list were transplanted. In the present study, we prospectively investigated whether implementation of the KDRI in our decision-making process to accept or decline an offered deceased donor kidney has helped us to evaluate the suitability of a deceased donor kidney for a recipient in order to increase the acceptance rate of high-quality donor kidneys. In cases where we decided not to transplant an offered deceased donor kidney, we identified the cause in a preset list of reasons. MATERIALS AND METHODS A prospective single-centre study was performed at the Antwerp University Hospital. All single-offered deceased donor kidneys between April 2015 and December 2016 from Eurotransplant to one of the patients (age >18 years) on the transplant waiting list were included. Kidneys offered in combination with another organ were excluded. Besides the data provided by Eurotransplant, the KDRI/ KDPI was calculated at the moment of an offer. This allowed the transplant physicians of our centre to immediately implement the KDRI/KDPI in their decision-making process to accept or decline an offered deceased donor kidney. All 10 donor characteristics need to be available to calculate the KDRI. However, for the parameters history of hypertension and diabetes status, it is possible to fill in unknown. In these cases, the calculator assumes that the donor has the same chance of having this condition as a randomly selected donor: 31% and 10%, respectively. If the HCV status is unknown, the calculator will assume the donor is negative for HCV. Missing data in any of the other fields makes the calculation of the KDRI impossible. Eurotransplant provides these donor characteristics at the moment of an offer, except ethnicity for ethical reasons. The ethnicity only influences the KDRI in case the donor is Black or African American. We decided not to fill in Black or African American in the field ethnicity, because the prevalence of this race is low in the Eurotransplant zone (<5%). TocalculatetheKDRI,weusedtheonlineKDRIcalculator of the Organ Procurement and Transplantation Network (OPTN) [4], which does not include non-donor factors. The reference population was all deceased donors in the USA with a kidney recovered for the purpose of transplantation during the prior calendar year ( ). For each offer to our centre, the clinician filled out a form where he took note of the KDRI/KDPI and whether or not the donor kidney was accepted and transplanted. When the clinician decided to decline an offered donor kidney, he noted on a predefined list the reason(s) why. The transplantation rate of this study was compared with the transplantation rate observed from January 2010 until December During this period, 20.7% of single-deceased donor kidneys (136 out of 657 offered organs) were transplanted. The KDRI/ KDPI was calculated retrospectivelyforall657offersduringthis period, by using the KDRI calculator of the OPTN During the prospective trial, we also analysed if there was a difference in recipients characteristics such as age, dialysis vintage, number of previous grafts and virtual panel-reactive antibodies (vpra), for those who received a low-kdri donor kidney compared with those who received a higher KDRI donor kidney. Therefore, we divided the recipients into two groups according to the KDRI of the donor. One group consisted of the recipients who received a donor kidney with a KDRI lower than the median of all transplanted donor kidneys in our centre during the prospective study, whereas the other group consisted of the ones who received a donor kidney with a KDRI higher than the median. To investigate whether implementation of the KDRI had an impact on our reasoning, we compared how often donor parameters included in the KDRI were evoked as a reason to decline an offer both before and after the implementation of the KDRI. In addition, smoking behaviour of the donor as a reason was also investigated. KDRI implementation and donor kidneys 1935
3 Table 1. Donor characteristics of all offered deceased donor kidneys that were either transplanted or not transplanted, from 1 January 2010 until 31 December 2013 Donor factor Median (Q1 Q3) or percentage P-value Transplanted (n ¼ 136) (20.7%) Not transplanted (n ¼ 521) (79.3%) Age (years) 44 (31 54) 55 (47 60) <0.001 Length (cm) 175 ( ) 175 ( ) Weight (kg) 75 (66 85) 80 (70 90) 0.28 Creatinine (mg/dl) 0.69 ( ) 0.80 ( ) <0.001 Diabetes (%) No: 85.3 No: Yes: 2.2 Yes: 9.2 Unknown: 12.5 Unknown: 18 Hypertension (%) No: 69.1 No: 46.3 <0.001 Yes: 19.1 Yes: 37.6 Unknown: 11.8 Unknown: 16.1 ECD (%) <0.001 DCD (%) Positive hepatitis C serology (%) Negative: 100 Negative: Positive: 0 Positive: 0 Unknown: 0 Unknown: 1.2 CVA (%) KDPI (%) 34 (18 58) 65 (47 79) <0.001 KDRI 0.85 ( ) 1.17 ( ) <0.001 Statistical analysis Power analysis (power ¼ 80%, significance ¼ 0.05) revealed that 247 deceased donor kidney offers needed to be included to see a significant increase in transplantation rate from 20.7% (of 657 deceased donor kidneys offered during the first study period) to 30%. Normality of the parameters was tested with QQ-plots and the Shapiro Wilk test. Since all parameters turned out to be not-normally distributed, we used the Mann Whitney U-test to compare parameters between the two groups and the Wilcoxon test to compare parameters within one group. For binary or categorical correlations, the chi-square test was used. To analyse if implementation of the KDRI resulted in a significantly higher transplantation rate, we performed a binary logistic regression with transplantation rate as outcome and the KDRI and study period as predictors. The median waiting time until transplantation after a first-declined kidney donor offer was calculated using the Kaplan Meier curve. All statistical analyses were performed using SPSS software, version 23. This study protocol was approved by the ethics committee of the Antwerp University Hospital. RESULTS From 1 January 2010 until 31 December 2013, 657 singledeceased donor kidneys were offered to one of the patients of the transplant waiting list of the Antwerp University Hospital, for which the KDRI was retrospectively calculated. Thus, this value was not taken into account in the decision to accept or decline a kidney offer. The donor characteristics of these offers are summarized in Table 1. From 1 April 2015 until 31 December 2016, 287 single-deceased donor kidneys were offered, for which the KDRI was prospectively calculated and included in the decision-making of acceptance or rejection of the offer. These characteristics are summarized in Table 2. Comparing both groups, there was a statistically significant difference between the transplanted and not transplanted donor kidneys for age, serum creatinine, the presence of arterial hypertension or diabetes, the number of DCDs and ECDs, and the KDRI/KDPI. The transplantation rate increased from 20.7% (136/657) in the retrospective control group to 26.1% (75/287) when the KDRI was implemented in the decision algorithm (P < 0.001). This corresponds to an absolute increase of 5.4% of accepted donor kidneys and a relative increase of 26%. Moreover, the median KDRI of all transplanted donor kidneys during the prospective trial was 0.97 (KDPI 47%), a value significantly higher than the median KDRI of 0.85 (KDPI 34%) during the retrospective trial (P ¼ 0.047). Of all offered deceased donor kidneys with a KDRI <1 (KDPI 50%), 38.7% (92/238) were transplanted during the retrospective trial, compared with 50.5% (47/93) from 1 April 2015 until 31 December 2016 (P ¼ 0.020). By comparing recipients who received a donor kidney with a KDRI lower than the median of all transplanted donor kidneys in our centre (KDRI <0.97) with those who received a donor kidney higher than the median during the prospective trial, we did not find a statistical significant difference concerning age (median: 51.5 and 55.0 years, respectively; P ¼ 0.159), dialysis vintage (median: 1039 and 857 days, respectively; P ¼ 0.291), number of previous grafts (median: both 0 previous grafts; P ¼ 0.369) and vpra (median: both 0%; P ¼ 0.277). Table 3 shows the comparison before and after the implementation of the KDRI of the reasons evoked to decline a donor kidney. Interestingly, donor age, history of hypertension, DCD and cerebrovascular accident (CVA) as a cause of death, all parameters included in the KDRI, were significantly less often evoked as a reason to decline an offer during the prospective study. Furthermore, smoking was also less frequently cited. Atotalof68%ofpatients(n ¼ 38) were transplanted after the decline of a first offer in the period from 1 April 2015 until E. Philipse et al.
4 Table 2. Donor characteristics of all offered deceased donor kidneys that were either transplanted or not transplanted, from 1 April 2015 until 31 December 2016 Donor factor Median (Q1 Q3) or percentage P-value Transplanted (n ¼ 75) (26.1%) Not transplanted (n ¼ 212) (73.9%) Age (years) 50 (39 54) 57 (48 63) <0.001 Length (cm) 172 ( ) 171 ( ) Weight (kg) 80 (70 90) 78 (67 90) Creatinine (mg/dl) 0.64 ( ) 0.82 ( ) Diabetes (%) No: 77.3 No: Yes: 0 Yes: 11.7 Unknown: 22.7 Unknown: 16.0 Hypertension (%) No: 64.0 No: Yes: 21.3 Yes: 37.6 Unknown: 14.7 Unknown: 15.5 ECD (%) <0.001 DCD (%) Positive hepatitis C serology (%) Negative: 98.7 Negative: Positive: 0 Positive: 0 Unknown: 1.3 Unknown: 0 CVA (%) KDPI (%) 47 (33 58) 74 (55 87) <0.001 KDRI 0.97 ( ) 1.26 ( ) <0.001 Table 3. Comparison before and after the implementation of the KDRI of the reasons evoked to decline a donor kidney Donor factor Retrospective study Prospective study P-value KDRI 0/206 (0%) 76/212 (35.8%) < Age 72/206 (35.0%) 29/212 (13.7%) < History of hypertension 47/206 (22.8%) 12/212 (5.7%) < History of diabetes 17/206 (8.3%) 10/212 (2.4%) High creatinine 43/206 (20.9%) 35/212 (16.5%) DCD 40/206 (19.4%) 21/212 (9.9%) CVA as the cause of death 9/206 (4.4%) 0/212 (0%) Smoking a 38/206 (18.4%) 19/212 (9.0%) For the retrospective study, the detailed reasons as reported above were available for 206 donor kidneys. a Besides smoking, all other parameters are included in the KDRI. December The median time to transplantation was 386 days (95% confidence interval days). Figure 1 shows the cumulative incidence plot of transplantation after a firstdeclined donor kidney during this period. The KDRI of this firstdeclined donor kidney (1.29; KDPI 75%) was significantly higher than the KDRI of the transplanted donor kidney (0.97; KDPI: 47%).Ofthesegroups,82%(n ¼ 31) indeed received a kidney with a lower KDRI (median 0.97; KDPI 47%), compared with a median KDRI of 1.33 (KDPI 78%) for the first-declined donor kidney. In 18% (n ¼ 7), the transplant candidate received a higher KDRI donor kidney after a first-declined donor kidney (median: 0.98; KDPI 48%), compared with a median KDRI of 0.82 (KDPI 30%) for the first-declined offered donor kidney. Immunological reasons and acute kidney injury (AKI) in combination with proteinuria were the main reasons to decline these low-kdri donor kidneys. Immunological reasons (n ¼ 2) consisted of an insufficient HLA matching. In both cases, there was no match in HLA- DR antigens. DR. AKI was reported as a reason to decline the offer in two cases. Of note, AKI is not necessarily associated with a high KDRI/KDPI. Indeed, when creatinine increases >1.5 mg/ dl, the KDPI increases only 1% per 1 mg/dl rise in creatinine. Therefore, we still were reluctant to accept offered deceased donor kidneys with AKI even with a low KDRI, especially in combination with proteinuria, which could suggest an underlying kidney disease. DISCUSSION The present study demonstrates that the introduction of the KDRI in our decision-making process to accept or decline an offered deceased donor kidney was associated with a relative increase in our transplantation rate by 26%. Additionally, we transplanted a significantly higher percentage of all offered deceased donor kidneys with a KDRI <1, compared with the retrospective trial. While this association does not prove causality, we also observed that factors included in the KDRI such as donor age, history of hypertension, DCD and CVA as a cause of death were significantly less frequently evoked as reasons to decline an offer after the implementation of the KDRI in our decision-making process. The same occurred with smoking, which was not retained as a significant factor influencing KDRI implementation and donor kidneys 1937
5 FIGURE 1: Cumulative incidence plot of transplantation after a first-declined kidney during the period from 1 April 2015 until 31 December outcomes in the Rao pivotal study. This suggests that KDRI implementation was indeed instrumental in increasing our transplantation rate. Additionally, investigating KDRI is a fruitful exercise for each transplant centre. This audit provides a rationale to discuss and possibly optimize the allocation policy within the medico-surgical team. How do our data compare with those reported in the literature? Although we succeeded in expanding our donor pool, the median KDRI of the transplanted kidneys in our centre was nevertheless still <1 (0.97) during the prospective trial. As a corollary, a substantial proportion (74%) of all offered deceased donor kidneys was still declined. Further, in our prospective study trial, only one (1.3%) patient received a donor kidney with a KDPI >85%, as compared to 9.7% of patients in the USA in 2012 [5]. Recent data show that the outcome of high-kdpi donor kidneys has become better over the years, with a 5-year graft survival of 56% for donor kidneys with a KDPI >85% [5]. Further, Massie et al. showed a long-term survival benefit in recipients who underwent a kidney transplantation with high-kdpi (70 80%) kidney compared with recipients who remain wait listed while waiting for a lower KDPI kidney [6]. However, this improved survival occurred only when the recipient was older than 50 years or when the waiting time was >33 months [6]. Therefore, it seems that we still are too critical in accepting offered deceased donor kidneys. However, it is difficult to compare our data with the reports above, since no data regarding the KDRI are available from European countries. In this respect, it is important to note that survival on dialysis is generally better in Europe as compared with the USA. This might explain the reluctance of some European centres and/or countries to accept high-kdri donors. For example, the 5-year survival rate for waitlisted patients in Europe who started dialysis in the period from 2004 to 2008 was 54% [7], higher than the reported 40% for patients who started dialysis in 2007 in the USA. Additionally, the median waiting time in the USA for a newly wait-listed candidate in 2009 was 3.6 years [8]. In Belgium, the median waiting time is <3 years. This obviously also influences our propensity to accept only the best kidney offers. Along this line, we demonstrated that the vast majority of transplant candidates for whom a first-offered deceased donor kidney was rejected, finally received with a short delay a donor kidney with a statistically significantly lower KDRI. The limitations of our study include a small sample size of a single centre and the fact that the KDRI is based on the donor population of the USA and is not yet validated in Europe. We also presumed that all donors were Caucasian because Eurotransplant does not provide any information about the race. This assumption is unlikely to bias our data as <5% of the Eurotransplant population is Black. Finally, our study does not provide data about patient and graft survival. While this was not the aim of the study, it seems important to have European data that would validate the association between KDRI and long-term graft survival. In summary, implementing the KDRI in our decision-making process increased the relative transplantation rate of our centre by26%.thekdriseemstobeahelpfultoolwhenconsidering whether to accept or decline a deceased donor kidney offer. CONFLICT OF INTEREST STATEMENT None declared. The results presented in this article have not been published previously in whole or part, except in abstract format. REFERENCES 1. Wolfe RA, Ashby VB, Milford EL et al. Comparison of mortality in all patients on dialysis, all patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. NEnglJMed1999; 341: Port FK, Bragg-Gresham JL, Metzger RA et al. Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors. Transplantation 2002; 74: Rao PS, Schaubel DE, Guidinger MK et al. A comprehensive risk quantification score for deceased donor kidneys: the kidney donor risk index. Transplantation 2009; 88: Online KDRI calculator of the OPTN. ces/allocation-calculators/kdpi-calculator/ 5. Rege A, Irish B, Castleberry A et al. Trends in usage and outcomes for expanded criteria donor kidney transplantation in the United States characterized by kidney donor profile index. Cureus 2016; 8: e887 DOI / cureus Massie AB, Luo X, Chow EKH et al. Survival benefit of primary deceased donor transplantation with high-kdpi kidneys. Am J Transplant 2014; 14: ERA-EDTA Registry: ERA-EDTA Registry Annual Report Amsterdam, The Netherlands: Academic Medical Center, Department of Medical Informatics, Saran R, Li Y, Robinson B et al. USDRS 2014 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis 2015; 66: Svii, S1 S305 Received: ; Editorial decision: E. Philipse et al.
The New Kidney Allocation System: What You Need to Know. Anup Patel, MD Clinical Director Renal and Pancreas Transplant Division Barnabas Health
The New Kidney Allocation System: What You Need to Know Anup Patel, MD Clinical Director Renal and Pancreas Transplant Division Barnabas Health ~6% of patients die each year on the deceased donor waiting
More informationScores in kidney transplantation: How can we use them?
Scores in kidney transplantation: How can we use them? Actualités Néphrologiques 2017 M Hazzan (Lille France ) Contents Scores to estimate the quality of the graft Scores to estimate old candidates to
More informationQuantification of the Early Risk of Death in Elderly Kidney Transplant Recipients
Wiley Periodicals Inc. C Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons Quantification of the Early Risk of Death in Elderly Kidney Transplant Recipients
More informationUpdate on Kidney Allocation
Update on Kidney Allocation 23rd Annual Conference Association for Multicultural Affairs in Transplantation Silas P. Norman, M.D., M.P.H. Associate Professor Division of Nephrology September 23, 2015 Disclosures
More informationDonor Quality Assessment
Donor Quality Assessment Francesc Moreso, MD, PhD Renal Transplant Unit Hospital Universitari Vall d Hebron Barcelona. Spain 4/9/2017 Donor Quality Assessment 1 What is the problem? Across all age ranges,
More informationTransplant Nephrology Update: Focus on Outcomes and Increasing Access to Transplantation
Transplant Nephrology Update: Focus on Outcomes and Increasing Access to Transplantation Titte R Srinivas, MD, FAST Medical Director, Kidney and Pancreas Transplant Programs Objectives: Describe trends
More informationThe New Kidney Allocation Policy: Implications for Your Patients and Your Practice
The New Kidney Allocation Policy: Implications for Your Patients and Your Practice Clinical Practice Today CME Co-provided by Learning Objectives Upon completion, participants should be able to: Explain
More informationOPTN/SRTR 2016 Annual Data Report: Preface
OPTN/SRTR 2016 Annual Data Report: Preface This Annual Data Report of the US Organ Procurement and Transplantation Network (OPTN) and the Scientific Registry of Transplant Recipients (SRTR) is the twenty-sixth
More informationThree Sides to Allocation. ECD Extended Criteria Donor
Kidney Allocation- Optimal Use of Deceased Donors The New US System..and impact on wait list management Three Sides to Allocation Justice Peter G Stock MD, PhD Utility Efficiency Standard Criteria Donor
More informationTransplant Update New Kidney Allocation System Transplant Referral Strategies. Antonia Harford, MD University of New Mexico
Transplant Update New Kidney Allocation System Transplant Referral Strategies Antonia Harford, MD University of New Mexico Financial Disclosures Doctor Harford has received financial support for dialysis
More informationPrevalence and Outcomes of Multiple-Listing for Cadaveric Kidney and Liver Transplantation
American Journal of Transplantation 24; 4: 94 1 Blackwell Munksgaard Copyright C Blackwell Munksgaard 23 doi: 1.146/j.16-6135.23.282.x Prevalence and Outcomes of Multiple-Listing for Cadaveric Kidney and
More informationAnswers to Your Questions about a Change in Kidney Allocation Policy What you need to know
Answers to Your Questions about a Change in Kidney Allocation Policy What you need to know Who are UNOS and the OPTN? The United Network for Organ Sharing (UNOS) is a nonprofit organization that operates
More informationThe New Kidney Allocation System (KAS) Frequently Asked Questions
The New Kidney Allocation System (KAS) Frequently Asked Questions Contents General: The Need for the New System and Key Implementation Details... 4 Why was the newly revised KAS necessary?... 4 What were
More informationFor more information about how to cite these materials visit
Author(s): Silas P. Norman, M.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Noncommercial Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/
More informationPredictors of cardiac allograft vasculopathy in pediatric heart transplant recipients
Pediatr Transplantation 2013: 17: 436 440 2013 John Wiley & Sons A/S. Pediatric Transplantation DOI: 10.1111/petr.12095 Predictors of cardiac allograft vasculopathy in pediatric heart transplant recipients
More informationThe Acceptable Mismatch program of Eurotransplant.
The Acceptable Mismatch program of Eurotransplant. Frans Claas Leiden University Medical Center Eurotransplant Reference Laboratory Leiden, the Netherlands. Hinterzarten, December 7, 2013 Main problem
More informationDonor and Recipient Age and the Allocation of Deceased Donor Kidneys for Transplantation
Donor and Recipient Age and the Allocation of Deceased Donor Kidneys for Transplantation July 26, 2006 Donor and Recipient Age and the Allocation of Deceased Donor Kidneys for Transplantation A paper prepared
More informationThe New Kidney Allocation System: What You Need to Know. Quality Insights Renal Network 3 Annual Meeting October 2, 2014
The New Kidney Allocation System: What You Need to Know Quality Insights Renal Network 3 Annual Meeting October 2, 2014 Pre Dialysis Era Dialysis Status in USA 500,000 patients on dialysis in 2013 100,000
More informationAre two better than one?
Are two better than one? Disclosures Ryutaro Hirose, MD Professor in Clinical Surgery University of California, San Francisco I have no relevant disclosures related to this presentation The PROBLEM There
More informationEchocardiography analysis in renal transplant recipients
Original Research Article Echocardiography analysis in renal transplant recipients S.A.K. Noor Mohamed 1*, Edwin Fernando 2, 1 Assistant Professor, 2 Professor Department of Nephrology, Govt. Stanley Medical
More informationShould Pediatric Patients Wait for HLA-DR-Matched Renal Transplants?
American Journal of Transplantation 2008; 8: 2056 2061 Wiley Periodicals Inc. C 2008 The Authors Journal compilation C 2008 The American Society of Transplantation and the American Society of Transplant
More informationGeographic Differences in Event Rates by Model for End-Stage Liver Disease Score
American Journal of Transplantation 2006; 6: 2470 2475 Blackwell Munksgaard C 2006 The Authors Journal compilation C 2006 The American Society of Transplantation and the American Society of Transplant
More informationOutcomes of Adult Dual Kidney Transplants by KDRI in the United States
American Journal of Transplantation 2013; 13: 2433 2440 Wiley Periodicals Inc. Brief Communication C Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons
More informationDeterminants of Discard of Expanded Criteria Donor Kidneys: Impact of Biopsy and Machine Perfusion
American Journal of Transplantation 2008; 8: 783 792 Blackwell Munksgaard C 2008 The Authors Journal compilation C 2008 The American Society of Transplantation and the American Society of Transplant Surgeons
More informationHong Kong Journal Nephrol of 2000;(2): Nephrology 2000;2(2): BR HAWKINS ORIGINAL A R T I C L E A point score system for allocating cadaver
Hong Kong Journal Nephrol of 2000;(2):79-83. Nephrology 2000;2(2):79-83. ORIGINAL A R T I C L E A point score system for allocating cadaveric kidneys for transplantation based on patient age, waiting time
More informationConcepts for Kidney Allocation
ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK Concepts for Kidney Allocation The Organ Procurement and Transplantation Network (OPTN) is seeking feedback regarding the use of two concepts in the allocation
More informationSurvival Outcomes Following Liver Transplantation (SOFT) Score: A Novel Method to Predict Patient Survival Following Liver Transplantation
American Journal of Transplantation 2008; 8: 2537 2546 Wiley Periodicals Inc. C 2008 The Authors Journal compilation C 2008 The American Society of Transplantation and the American Society of Transplant
More informationKidney Transplant in the Elderly. Robert Santella, M.D., F.A.C.P.
Kidney Transplant in the Elderly! Robert Santella, M.D., F.A.C.P. Incident Rate of ESRD by Age Age 75+ 65-74 From US Renal Data System, 2012 Should there be an age limit? Various guidelines: Canadian,
More informationChapter 6: Transplantation
Chapter 6: Transplantation Introduction During calendar year 2012, 17,305 kidney transplants, including kidney-alone and kidney plus at least one additional organ, were performed in the United States.
More informationDeveloping a Kidney Waiting List Calculator
Developing a Kidney Waiting List Calculator Jon J. Snyder, PhD* Nicholas Salkowski, PhD, Jiannong Liu, PhD, Kenneth Lamb, PhD, Bryn Thompson, MPH, Ajay Israni, MD, MS, and Bertram Kasiske, MD, FACP *Presenter
More informationKIDNEY TRANSPLANTATION IS THE
ORIGINAL CONTRIBUTION Deceased-Donor Characteristics and the Survival Benefit of Kidney Transplantation Robert M. Merion, MD Valarie B. Ashby, MA Robert A. Wolfe, PhD Dale A. Distant, MD Tempie E. Hulbert-Shearon,
More informationNational Transplant Guidelines
National Transplant Guidelines Quo Vadis? Scott Campbell, Princess Alexandra Hospital, Brisbane. Quo Vadis Whither goest thou? Where the F#$% do we go next? Overview WAITING LIST ELIGIBILITY ALLOCATION
More informationImplications of the Statewide Sharing Variance on Kidney Transplantation Geographic Inequity and Allocation Efficiency
Implications of the Statewide Sharing Variance on Kidney Transplantation Geographic Inequity and Allocation Efficiency Ashley E Davis 1, 2, Sanjay Mehrotra 1, 2, 3, Lisa McElroy 2,4, John J Friedewald
More informationAssociation of Kidney Transplantation with Survival in Patients with Long Dialysis Exposure
Article Association of Kidney Transplantation with Survival in Patients with Long Dialysis Exposure Caren Rose,* Jagbir Gill,* and John S. Gill* Abstract Background and objectives Evidence that kidney
More informationQuestions and Answers for Transplant Candidates about the Kidney Allocation System
TA L K I N G A B O U T T R A N S P L A N TAT I O N Questions and Answers for Transplant Candidates about the Kidney Allocation System United Network for Organ Sharing (UNOS) is a non-profit charitable
More informationOrgan Procurement and Transplantation Network
OPTN Organ Procurement and Transplantation Network POLICIES This document provides the policy language approved by the OPTN/UNOS Board at its meeting in June 2015 as part of the Operations and Safety Committee
More informationOPTN/SRTR 2014 ANNUAL DATA REPORT
OPTN/SRTR 14 ANNUAL DATA REPORT KIDNEY A Hart 1, J M Smith 2,3, M A Skeans 3, S K Gustafson 3, D E Stewart 4,5, W S Cherikh 4,5, J L Wainright 4,5, G Boyle 4,5, J J Snyder 3,6, B L Kasiske 1,3, A K Israni
More informationU.S. changes in Kidney Allocation
U.S. changes in Kidney Allocation Match kidneys with longest survival to patients with longest survival No parallel matching for kidneys with lower survival potential Decrease discard of kidneys with lower
More informationReduced graft function (with or without dialysis) vs immediate graft function a comparison of long-term renal allograft survival
Nephrol Dial Transplant (2006) 21: 2270 2274 doi:10.1093/ndt/gfl103 Advance Access publication 22 May 2006 Original Article Reduced graft function (with or without dialysis) vs immediate graft function
More informationThe Art and Science of Increasing Authorization to Donation
The Art and Science of Increasing Authorization to Donation OPO Metrics: The Good, The Bad, and The Maybe Charlotte Arrington, MPH Arbor Research Collaborative for Health Alan Leichtman, MD University
More informationRenal Transplantation: Allocation challenges and changes. Renal Transplantation. The Numbers 1/13/2014
Renal Transplantation: Allocation challenges and changes Mark R. Wakefield, M.D., F.A.C.S. Associate Professor of Surgery/Urology Director Renal Transplantation Renal Transplantation Objectives: Understand
More information. Time to transplant listing is dependent on. . In 2003, 9.1% of all prevalent transplant. . Patients with diabetes mellitus are less
Chapter 5: Joint Analyses with UK Transplant in England and Wales; Access to the Renal Transplant Waiting List, Time to Listing, Diabetic Access to Transplantation and the Influence of Social Deprivation
More informationPeter Chang,* Jagbir Gill,* James Dong,* Caren Rose,* Howard Yan,* David Landsberg,* Edward H. Cole, and John S. Gill*
Article Living Donor Age and Kidney Allograft Half-Life: Implications for Living Donor Paired Exchange Programs Peter Chang,* Jagbir Gill,* James Dong,* Caren Rose,* Howard Yan,* David Landsberg,* Edward
More informationPatient Name: MRN: DOB: Treatment Location:
Page 1 of 5 I. TO (Required) This Section is required to be completed by all patients who undergo kidney transplant surgery. I hereby consent to and authorize Dr. and his/her assistant(s), including supervised
More informationEarly Changes in Kidney Distribution under the New Allocation System
Early Changes in Kidney Distribution under the New Allocation System Allan B. Massie,* Xun Luo,* Bonnie E. Lonze,* Niraj M. Desai,* Adam W. Bingaman, Matthew Cooper, and Dorry L. Segev* *Department of
More informationKidney Allocation- Will it ever be fair? Peter G Stock MD, PhD UCSF Department of Surgery. Would you accept this offer?
Kidney Allocation- Will it ever be fair? Peter G Stock MD, PhD UCSF Department of Surgery Question 1: A 19 y/o deceased donor kidney (O mismatch) from NYC is allocated to a 72 y/o highly sensitized caucasian
More informationUser Guide. A. Program Summary B. Waiting List Information C. Transplant Information
User Guide This report contains a wide range of useful information about the kidney transplant program at (FLMR). The report has three main sections: A. Program Summary B. Waiting List Information The
More informationFAIRNESS/EQUITY UTILITY/EFFICACY EFFICIENCY. The new kidney allocation system (KAS) what has it done? 9/26/2018. Disclosures
The new kidney allocation system (KAS) what has it done? Disclosures No financial disclosure Ryutaro Hirose, MD Professor in Clinical Surgery University of California San Francisco Objectives Describe
More informationWait List Management. John J. Friedewald, Darshika Chhabra, and Baris Ata. The US Transplant System. National Wait List
Wait List Management John J. Friedewald, Darshika Chhabra, and Baris Ata 4 Abbreviations CDC Centers for Disease Control and Prevention CPRAs Calculated panel reactive antibodies DCD Donation after cardiac
More informationLong-Term Renal Allograft Survival in the United States: A Critical Reappraisal
American Journal of Transplantation 2011; 11: 450 462 Wiley Periodicals Inc. C 2010 The Authors Journal compilation C 2010 The American Society of Transplantation and the American Society of Transplant
More informationKidney Transplant Outcomes In Elderly Patients. Simin Goral MD University of Pennsylvania Medical Center Philadelphia, Pennsylvania
Kidney Transplant Outcomes In Elderly Patients Simin Goral MD University of Pennsylvania Medical Center Philadelphia, Pennsylvania Case Discussion 70 year old Asian male, neuropsychiatrist, works full
More informationkidney OPTN/SRTR 2012 Annual Data Report:
kidney wait list 18 deceased donation 22 live donation 24 transplant 26 donor-recipient matching 28 outcomes 3 pediatric transplant 33 Medicare data 4 transplant center maps 43 A. J. Matas1,2, J. M. Smith1,3,
More informationTransplant Options for Patients: Choices and Consequences. Olwyn Johnston Medical Director Kidney Transplantation Vancouver General Hospital
Transplant Options for Patients: Choices and Consequences Olwyn Johnston Medical Director Kidney Transplantation Vancouver General Hospital BC Kidney Days October 6 th 2017 Non contributory Conflict of
More informationAccess and Outcomes Among Minority Transplant Patients, , with a Focus on Determinants of Kidney Graft Survival
American Journal of Transplantation 2010; 10 (Part 2): 1090 1107 Wiley Periodicals Inc. Special Feature No claim to original US government works Journal compilation C 2010 The American Society of Transplantation
More informationHome Hemodialysis or Transplantation of the Treatment of Choice for Elderly?
Home Hemodialysis or Transplantation of the Treatment of Choice for Elderly? Miklos Z Molnar, MD, PhD, FEBTM, FERA, FASN Associate Professor of Medicine Division of Nephrology, Department of Medicine University
More informationThe Kidney Allocation System Changed in a Substantive Way on December 5, Your Patients Have Been, and Will Be, Affected by These Changes
The Kidney Allocation System Changed in a Substantive Way on December 5, 2014 Your Patients Have Been, and Will Be, Affected by These Changes 1 The New Kidney Allocation System Terms of Importance Pediatric
More informationChapter 7. Australian Waiting List. ANZDATA Registry 39th Annual Report. Data to 31-Dec-2015
Chapter 7 Australian Waiting List 216 ANZDATA Registry 39th Annual Report Data to 31-Dec-215 Stock and Flow The waiting list data reported here are derived from the Australian National Organ Matching System
More informationKidney, Pancreas and Liver Allocation and Distribution
American Journal of Transplantation 2012; 12: 3191 3212 Wiley Periodicals Inc. Special Article C Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons doi:
More informationKidney and Pancreas Transplantation in the United States,
American Journal of Transplantation 2006; 6 (Part 2): 1153 1169 Blackwell Munksgaard No claim to original US government works Journal compilation C 2006 The American Society of Transplantation and the
More informationTransplant Center Quality Assessment Using a Continuously Updatable, Risk-Adjusted Technique (CUSUM)
American Journal of Transplantation 2006; 6: 313 323 Blackwell Munksgaard C 2005 The Authors Journal compilation C 2006 The American Society of Transplantation and the American Society of Transplant Surgeons
More informationClinical Study Over Ten-Year Kidney Graft Survival Determinants
International Nephrology Volume 2012, Article ID 302974, 5 pages doi:10.1155/2012/302974 Clinical Study Over Ten-Year Kidney Graft Survival Determinants Anabela Malho Guedes, 1, 2 Jorge Malheiro, 1 Isabel
More informationLIVE KIDNEY DONOR RISK PREDICTION ; NEW PARADIGM, NEW CALCULATORS PEDRAM AHMADPOOR MD
LIVE KIDNEY DONOR RISK PREDICTION ; NEW PARADIGM, NEW CALCULATORS PEDRAM AHMADPOOR MD Outline: PART 1 : Update on safety of nephrectomy for living donor candidate PART 2 : Latest guideline recommendation
More informationChronic renal histological changes at implantation and subsequent deceased donor kidney transplant outcomes: a single-centre analysis
Chronic renal histological changes at implantation and subsequent deceased donor kidney transplant outcomes: a single-centre analysis Benedict Phillips 1, Kerem Atalar 1, Hannah Wilkinson 1, Nicos Kessaris
More informationJ Am Soc Nephrol 14: , 2003
J Am Soc Nephrol 14: 208 213, 2003 Kidney Allograft and Patient Survival in Type I Diabetic Recipients of Cadaveric Kidney Alone Versus Simultaneous Pancreas/Kidney Transplants: A Multivariate Analysis
More informationNew National Allocation Policy for Deceased Donor Kidneys in the United States and Possible Effect on Patient Outcomes
New National Allocation Policy for Deceased Donor Kidneys in the United States and Possible Effect on Patient Outcomes Ajay K. Israni,* Nicholas Salkowski,* Sally Gustafson,* Jon J. Snyder,* John J. Friedewald,
More informationCandidates about. Lung Allocation Policy. for Transplant. Questions & A n s we r s TA L K I N G A B O U T T R A N S P L A N TAT I O N
TA L K I N G A B O U T T R A N S P L A N TAT I O N Questions & A n s we r s for Transplant Candidates about Lung Allocation Policy U N I T E D N E T W O R K F O R O R G A N S H A R I N G What are the OPTN
More informationSocial deprivation, ethnicity and access to kidney transplantation in England and Wales. Udaya Udayaraj
Social deprivation, ethnicity and access to kidney transplantation in England and Wales Udaya Udayaraj Introduction (1) Kidney transplantation Improved survival compared to remaining on dialysis Better
More informationA Guide to Better Living
Transplantation What Is a Kidney Transplant? Kidney transplantation is placing a kidney from one person (donor) into a patient with kidney failure (recipient). This is done by surgery where the donated
More informationHasan Fattah 3/19/2013
Hasan Fattah 3/19/2013 AASK trial Rational: HTN is a leading cause of (ESRD) in the US, with no known treatment to prevent progressive declines leading to ESRD. Objective: To compare the effects of 2 levels
More informationCurrent status of kidney and pancreas transplantation in the United States,
American Journal of Transplantation 25; 5 (Part 2): 94 915 Blackwell Munksgaard Blackwell Munksgaard 25 Current status of kidney and pancreas transplantation in the United States, 1994 23 Gabriel M. Danovitch
More informationLiving Donor Paired Exchange (LDPE)
Living Donor Paired Exchange (LDPE) Why do we need Living Donation? 3,796 patients waiting for an organ transplant 2,679 (71%) waiting for a kidney transplant 249 people died while waiting for an organ
More informationORIGINAL ARTICLE. Eric F. Martin, 1 Jonathan Huang, 3 Qun Xiang, 2 John P. Klein, 2 Jasmohan Bajaj, 4 and Kia Saeian 1
LIVER TRANSPLANTATION 18:914 929, 2012 ORIGINAL ARTICLE Recipient Survival and Graft Survival are Not Diminished by Simultaneous Liver-Kidney Transplantation: An Analysis of the United Network for Organ
More informationInfluence of kidney offer acceptance behavior on metrics of allocation efficiency
Accepted: 11 July 2017 DOI: 10.1111/ctr.13057 ORIGINAL ARTICLE Influence of kidney offer acceptance behavior on metrics of allocation efficiency Andrew Wey 1 Nicholas Salkowski 1 Bertram L. Kasiske 1,2
More informationjournal of medicine The new england
The new england journal of medicine established in 1812 february 5, 2004 vol. 350 no. 6 Effect of Changing the Priority for HLA Matching on the Rates and Outcomes of Kidney Transplantation in Minority
More informationRESEARCH. Variation between centres in access to renal transplantation in UK: longitudinal cohort study
Variation between centres in access to renal transplantation in UK: longitudinal cohort study R Ravanan, consultant nephrologist, 1 U Udayaraj, consultant nephrologist, 1 D Ansell, director, 2 D Collett,
More informationBK virus infection in renal transplant recipients: single centre experience. Dr Wong Lok Yan Ivy
BK virus infection in renal transplant recipients: single centre experience Dr Wong Lok Yan Ivy Background BK virus nephropathy (BKVN) has emerged as an important cause of renal graft dysfunction in recent
More informationEmbracing the Magic: Increasing Organ Acceptance Rates Through Data Review and Risk Stratification
Embracing the Magic: Increasing Organ Acceptance Rates Through Data Review and Risk Stratification Presented by: Sandy Felty, RN, MSN, MHA Lynette Martin del Campo, RN, MSN, FNP-C Sharon Norfles, RN, BSN
More informationThe pediatric end-stage liver disease (PELD) score
Selection of Pediatric Candidates Under the PELD System Sue V. McDiarmid, 1 Robert M. Merion, 2 Dawn M. Dykstra, 2 and Ann M. Harper 3 Key Points 1. The PELD score accurately predicts the 3 month probability
More informationINTERIM REPORT ON KIDNEY TRANSPLANTATION
INTERIM REPORT ON KIDNEY TRANSPLANTATION 5 YEAR REPORT (1 OCTOBER 2011 30 SEPTEMBER 2016) PUBLISHED MARCH 2017 PRODUCED IN COLLABORATION WITH NHS ENGLAND Contents 1 Executive Summary... 1 2 Introduction...
More informationKidney and Pancreas Transplantation in the United States, : Access for Patients with Diabetes and End-Stage Renal Disease
American Journal of Transplantation 29; 9 (Part 2): 894 96 Wiley Periodicals Inc. No claim to original US government works Journal compilation C 29 The American Society of Transplantation and the American
More informationon the number of organs transplanted per donor. Donor factors that affect the number of organs transplanted per donor
Donor factors that affect the number of organs transplanted per donor Background Demographic factors and factors from donors medical and social history influence the number of organs transplanted per donor.
More informationSylwia Mizia, 1 Dorota Dera-Joachimiak, 1 Malgorzata Polak, 1 Katarzyna Koscinska, 1 Mariola Sedzimirska, 1 and Andrzej Lange 1, 2. 1.
Bone Marrow Research Volume 2012, Article ID 873695, 5 pages doi:10.1155/2012/873695 Clinical Study Both Optimal Matching and Procedure Duration Influence Survival of Patients after Unrelated Donor Hematopoietic
More informationObesity has become an epidemic in the United States
Original Clinical ScienceçGeneral Selected Mildly Obese Donors Can Be Used Safely in Simultaneous Pancreas and Kidney Transplantation Tarek Alhamad, MD, MS, 1,2 Andrew F. Malone, MD, 1 Krista L. Lentine,
More informationWe have no disclosures
Pulmonary Artery Pressure Changes Differentially Effect Survival in Lung Transplant Patients with COPD and Pulmonary Hypertension: An Analysis of the UNOS Registry Kathryn L. O Keefe MD, Ahmet Kilic MD,
More informationReceiving a Kidney Transplant in the Ninth Decade of Life
Trends Edmund in Transplant. Huang and 2011;5:121-7 Suphamai Bunnapradist: Receiving a Kidney Transplant in the Ninth Decade of Life Receiving a Kidney Transplant in the Ninth Decade of Life Edmund Huang
More informationCorneal transplantation: HLA and age
L Aquila, 24 novembre 2012 Corneal transplantation: HLA and age Federico Genzano Besso*, Paola Magistroni, Piera Santoro*, Silvano Battaglio*, Raffaella Giacometti, Morteza Mansouri and Antonio Amoroso
More informationTrends in Organ Donation and Transplantation in the United States,
American Journal of Transplantation 2010; 10 (Part 2): 961 972 Wiley Periodicals Inc. Special Feature No claim to original US government works Journal compilation C 2010 The American Society of Transplantation
More informationOrgan Donation & Allocation. Nance Conney Thomas E. Starzl Transplantation Institute
Organ Donation & Allocation Nance Conney Thomas E. Starzl Transplantation Institute History of Transplantation Dr. Sushruta second century B.C. Solid Organ Transplantation 1954 Living-Related Kidney (Dr.
More informationKidney vs. Liver: Where are We Really with Allocation in Kidney Transplantation?
Kidney vs. Liver: Where are We Really with Allocation in Kidney Transplantation? Mark D. Stegall,, MD Chair, UNOS/OPTN Kidney Allocation Review Subcommittee Different Allocation Factors Liver Wait list
More informationOUTCOMES OF DECEASED DONOR KIDNEY OFFERS TO PATIENTS AT THE TOP OF THE WAITING LIST ANNE HUML, MD
OUTCOMES OF DECEASED DONOR KIDNEY OFFERS TO PATIENTS AT THE TOP OF THE WAITING LIST By ANNE HUML, MD Submitted in partial fulfillment of the requirements for the degree of Master of Science Clinical Research
More informationRenal Transplant Registry Report 2008
Renal Transplant Registry Report 28 Contents:. Introduction Page 2. Summary of transplant activity 27-28 Page 2 3. Graft and Patient Survival analysis 989-28 Page 3 4. Acute rejection 989-28 Page 24. Comparison
More informationAN EXAMINATION OF CONTEMPORARY CHALLENGES IN DECEASED DONOR KIDNEY ALLOCATION
AN EXAMINATION OF CONTEMPORARY CHALLENGES IN DECEASED DONOR KIDNEY ALLOCATION by Caren Lee Rose MSc, Dalhousie University, 2003 BSc, University of British Columbia, 2000 A THESIS SUBMITTED IN PARTIAL FULFILLMENT
More informationLong-term prognosis of BK virus-associated nephropathy in kidney transplant recipients
Original Article Kidney Res Clin Pract 37:167-173, 2018(2) pissn: 2211-9132 eissn: 2211-9140 https://doi.org/10.23876/j.krcp.2018.37.2.167 KIDNEY RESEARCH AND CLINICAL PRACTICE Long-term prognosis of BK
More informationThe time interval between kidney and pancreas transplantation and the clinical outcomes of pancreas after kidney transplantation
Clin Transplant 2012: 26: 403 410 DOI: 10.1111/j.1399-0012.2011.01519.x ª 2011 John Wiley & Sons A/S. The time interval between kidney and pancreas transplantation and the clinical outcomes of pancreas
More informationSubstance Use Among Potential Kidney Transplant Candidates and its Impact on Access to Kidney Transplantation: A Canadian Cohort Study
Substance Use Among Potential Kidney Transplant Candidates and its Impact on Access to Kidney Transplantation: A Canadian Cohort Study Evan Tang 1, Aarushi Bansal 1, Michelle Kwok 1, Olusegun Famure 1,
More informationSimultaneous Pancreas Kidney Transplantation:
Simultaneous Pancreas Kidney Transplantation: What is the added advantage, and for whom? Alexander Wiseman, M.D. Associate Professor, Division of Renal Diseases and Hypertension Medical Director, Kidney
More informationKøbenhavns Universitet
university of copenhagen Københavns Universitet Survival Benefit in Renal Transplantation Despite High Comorbidity Sørensen, Vibeke Rømming; Heaf, James Goya; Wehberg, Sonja; Sørensen, Søren Schwartz Published
More informationSurvival Benefit-Based Deceased-Donor Liver Allocation
American Journal of Transplantation 2009; 9 (Part 2): 970 981 Wiley Periodicals Inc. No claim to original US government works Journal compilation C 2009 The American Society of Transplantation and the
More informationCombined Effect of Donor and Recipient Risk on Outcome After Liver Transplantation: Research of the Eurotransplant Database
LIVER TRANSPLANTATION 21:1486 1493, 2015 ORIGINAL ARTICLE Combined Effect of Donor and Recipient Risk on Outcome After Liver Transplantation: Research of the Eurotransplant Database Joris J. Blok, 1 Hein
More informationVirtual Crossmatch in Kidney Transplantation
Virtual Crossmatch in Kidney Transplantation Shiva Samavat Associate Professor of Nephrology Labbafinejad Hospital SBMU 2018.11.21 All transplant candidates are screened to determine the degree of humoral
More information